A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?

Pain

Vomiting

Constipation

Bradycardia

Answer and Explanation

The Correct Answer is A

A. Pain: This is the most common and significant symptom of a vaso-occlusive crisis in sickle cell disease. The sickled cells block blood flow, leading to intense pain and tissue ischemia.

B. Vomiting: Vomiting is not a typical finding associated with a vaso-occlusive crisis. While it may occur due to other complications or treatments, it is not directly related to the crisis itself.

C. Constipation: Constipation is not a typical symptom of a vaso-occlusive crisis. It may occur due to decreased activity or medication side effects, but it is not directly linked to the sickle cell crisis.

D. Bradycardia: Bradycardia is not expected in a vaso-occlusive crisis. The crisis usually involves pain and stress, which might increase the heart rate rather than decrease it.

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Correct Answer is C

Explanation

A. "Your newborn will receive the first DTaP vaccine during the initial well-baby visit.": The first dose of DTaP is typically given at 2 months, not at the newborn stage.

B. "Your newborn should receive an immunization for MMR at 6 months.": The MMR vaccine is usually administered at 12-15 months, not at 6 months.

C. "Your newborn is scheduled to have a hepatitis B vaccine prior to discharge.": Hepatitis B vaccine is recommended to be given within 24 hours of birth as the first dose of a series.

D. "Your newborn should receive the PCV vaccine two times prior to his first birthday.": The pneumococcal conjugate vaccine (PCV) schedule starts at 2 months with multiple doses, but not specifically "two times" before the first birthday.

A. Capillary refill less than 2 seconds B. Tingling in the right foot C. 2+ right pedal pulse D. Respiratory rate 24/min

Correct Answer is B

Explanation

A. Capillary refill less than 2 seconds: A capillary refill time of less than 2 seconds indicates good peripheral circulation, which is normal and not a cause for concern in this context. It is not the priority.

B. Tingling in the right foot Rationale: Tingling (paraesthesia) can be a sign of nerve damage or compromised circulation, which may indicate complications such as compartment syndrome. This is a priority finding because it can lead to severe consequences if not addressed promptly.

C. 2+ right pedal pulse Rationale: A 2+ pedal pulse indicates a normal pulse strength, which suggests that there is adequate blood flow to the extremity. It is not a priority compared to the potential for neurological or circulatory compromise.

D. Respiratory rate 24/min Rationale: A respiratory rate of 24/min is within the normal range for a school-age child (18-30 breaths per minute). While it is important to monitor vital signs, it is not a priority concern related to the fracture.

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A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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